Intergenerational Relations and Family Therapy Research'' What We Can Learn from Other Disciplines

Although there are a number of theories regarding intergenerational relations within the family therapy field, few of these theories have been empirically examined. Indeed, intergenerational family research is in its infancy in the family therapy world. This article explores the literature on intergenerational relations within the sociological and psychosociological disciplines in order to understand what is known, and how this information could assist family therapy researchers interested in developing systematic studies of intergenerational relations for the family therapy field.     

Cordelia, Lear, and forgiveness

Painful human interactions are often followed by urges to forgive, be forgiving, or seek forgiveness. The insight analysands develop into their transferences highlights their finding gratification in constantly reenacting painful interactions. Their new understanding can make forgiveness seem irrelevant; waiving the question of forgiveness might then seem the wiser course to follow. Also thrown into question is whether total forgiveness of self and others can ever be achieved. Shakespeare's The Tragedy of King Lear raises these questions. There we encounter, first, the painful interaction of Cordelia and Lear and, finally, Cordelia's response, "No cause, no cause," to a dying Lear's begging her forgiveness for having initially treated her cruelly. Cordelia's response seems to be waiving the question of guilt and forgiveness, but could it be wholehearted? In a search for answers, a reading of Cordelia's and Lear's lines is interwoven with interpretations of unconscious conflict that might be considered were one to encounter clinically a "Cordelia" abused by an aging and failing father at a turning point in her womanly development. Unconsciously, it is concluded, unforgivingness persists alongside the loving, insightful waiving of forgiveness made possible by higher-level ego functioning. Methodological reflections on reading and interpretation are included.     

HIV-related neurocognitive impairment--a review

Neurocognitive impairments following central nervous system opportunistic infections and HIV-associated dementia (HAD) were common clinical features of HIV infection prior to anti-retroviral therapy. As HIV infection has evolved from an invariably fatal disease with a poor prognosis to a condition requiring long-term management, HIV-related neurocognitive disorders have been the subject of increasing research. This review will examine the recent changes in the understanding of the HIV-associated neurocognitive disorders (HAND) including the changing epidemiology, risk factors associated with its development, methods for screening for the disorders and evolving treatment options.     

糖尿病的治疗现状与糖尿病教育

糖尿病的发病率逐年升高,发展中国家尤为显著,我国作为世界上主要的发展中国家,如何作好糖尿病的预防、治疗和管理工作,已经成为一个重要社会问题。通过对糖尿病的现状及不同治疗模式对糖尿病患者血糖控制的影响等方面加以阐述,以期引起社会关注,加强糖尿病教育,降低糖尿病的发病率,改善糖尿病患者的治疗效果。     

WHAT CONSTITUTES AN ‘APPROPRIATE PSYCHOLOGY’ FOR THE DEVELOPING WORLD?

The impact of psychology on the developing world has begun to receive some attention, but there is a need for theoretical concepts in order to provide a framework for critical discussion. Using the concepts ‘dual perception’ and ‘parallel growth’ (Moghaddam and Taylor 1985) as a framework, the concept of ‘appropriate psychology’ is introduced to assess the transfer of psychology from the developed to the developing world. Six criteria for evaluating appropriateness are discussed: self-reliance, needs responsiveness, cultural compatability, institutional feasibility, economic suitability and political practicality.     

A problem-posing educational methodology for the prevention of HIV / AIDS

The problem-posing methodology of Brazilian educator Paulo Freire, using the reading circle approach previously deployed in successful literacy campaigns in developing countries, is introduced for application in AIDS information programs. The basis of this educational process is the dialogue where those to be educated resolve their problems by evaluating information critically, capturing concepts by codification and decodification, and transmitting information by creating relevant educational materials. Health circles are organized with women as educators to impart knowledge about AIDS and HIV: definitions, epidemiological components (sex, age, and risk behavior), means of transmission, stages of the progression of AIDS, prevention of HIV infection, and tests for detecting HIV antibodies. The dialogue explores knowledge and feelings about AIDS and how it affects life in the community reveals personal experiences and accounts of knowing someone who was HIV-positive, and develops action plans to minimize AIDS cases in the community. The Latin population of California, mainly of Mexican origin, with low levels of education, income, and acculturation and a high incidence of AIDS, is an appropriate target of such intervention. In 1980, there were 12.3 million people of Hispanic origin in the US. In August 1990, there were 143,280 persons diagnoses with AIDS according to the Centers for Disease Control. 78,878 of these (55%) were Anglos, and 21,752 (15%) were Hispanics. Among the Anglos, the incidence was 300/million inhabitants, while among Hispanics, it was 1059/million, a 3-field higher rate.     

Basic and applied research in developing countries: The search for an evaluation strategy

Although activities in basic and applied research in developing countries (DCs) are guided by universal scientific principles, there are important differences in the way in which science is practiced from that of the industrialized world. Isolation from the mainstream of scientific activity, the need for the development of an indigenous scientific capacity, the lack of a critical mass of researchers with respect to most fields of knowledge, and the urgency of developing better and more efficient communication channels, are some of the aspects that set apart the scientific activity of the developing world. In particular, the need to develop local "new" science aimed at solving pressing problems of a local nature suggests the existence of a different set of conditions from those found in scientifically-advanced countries. In the present article we look at the ways the special circumstances of science in DCs will affect the application of evaluation criteria, using bibliometric data on research in Mexico as an example.     

Dialogue Concerning Natural Appropriation

Two utilitarian defenses, traceable to Bentham and Mill, arecommonly offered for patents. It is contended that patents induce innovation, and thatpatents induce disclosure of innovation. Patents on some or all of the human genomepose particular challenges for these defenses. In the first instance, patents on nucleotidesequences entail the perverse notion of human reproduction qua infringement. In the second place, when such patents are available (as is presently the case), the two defenses involve a counterfactual claim, viz., that if there were no such patents, biotechnological progress would wane. Even if these challenges are met, concerns about respect for humanity generate opposition to property interests in compounds manipulated outside the human body but significantly homologous to compounds found in humans. This stance about things human might appear to commit the fallacy of division. In a dialogue between a Kantian and a utilitarian, arguments for and against property interests in the human genome are presented.     

DNA-sequence patenting: National Society of Genetic Counselors (NSGC) position paper

In November 2000, the Genetic Services Committee of the National Society of Genetic Counselors (NSGC) convened a working group to draft a position paper on patenting of DNA-sequences. The mandate of the group was to produce general position statements that support the perspective and needs of consumers of DNA-based genetic tests and therapies (our patients and their families) and participants in DNA-based genetic research. After review and discussion of the literature on DNA-sequence patenting issues, the working group drafted position statement points that support current United States Patent and Trademark Office (USPTO) guidelines; broad licensing of DNA-sequence patents; nonenforcement of DNA-sequence patents in noncommercial research; reasonable royalty rates; an informed consent process for research participants that discloses whether they can share in any financial rewards relating to the project; the development of guidelines for licensing of DNA-sequence patents; and the establishment of oversight organizations to monitor licensing of DNA-sequence patents. These position statements were approved by the NSGC Board of Directors in the fall of 2001.     

Lifestyles of virtual world residents: living in the on-line game "lineage".

This study was conducted to explore the lifestyles of online game players who have adopted the virtual world as part of their life. An online survey was conducted on players of an Internet-based game, Lineage. Lineage is the largest online game where people assume new identities and play various roles in a virtual environment, accommodating over 6 million users worldwide. A total of 4,786 game players participated in this survey, and their lifestyles were compared with their values and attitudes in the virtual world. Upon classification of their real-world lifestyles, their tendencies and desires were compared to lifestyles in the virtual world. This study showed that game players have developed their own distinctive lifestyles, and their lifestyles were a strong criterion for explaining behavior patterns and desires in the virtual world. Lifestyles were classified into three general categories: (1) single-oriented player, (2) community-oriented player, and (3) off-Real world player. Each group displayed distinct differences in their values and game activities, as well as in their anti-social behavior tendencies. The differences reflected not only their personality but also their socio-economic status within the virtual world, which is constructed through game activities. This study serves as a model to understand how players from different real-life backgrounds will behave in various game features and how they adopt the virtual world for their new social identities.     

Knowing What NOT To Do Is a Critical Job Skill: Evidence from 10 different scoring methods

Situational judgment tests (SJTs) have become an increasingly important tool for predicting employee performance; however, at least two key areas warrant further investigation. First, prior studies of SJTs have generally relied on samples from the western world, leaving open the question of the validity of using SJTs in the developing world where the majority of the world's workforce resides. Second, there is currently no standardized, theoretically‐based method for the development and scoring of SJTs. Therefore, SJTs are highly domain‐specific and must be developed anew for each new context. We report the results of three studies, conducted in India, that aim to: (1) test the cross‐cultural validity of SJTs in a non‐western context, and (2) examine the differential validity of 10 different approaches to scoring SJTs, some of which have the potential to resolve the problem of developing a theoretically‐infused, standardized approach to scoring and future development.     

Beyond opposites: Extending the cultural boundaries of CBT methodology

In cognitive behavioural therapy (CBT), a black or white perception of the world is generally considered to be a distortion of reality. This paper addresses the issue of bipolar or categorical thinking and its role in creating disturbance. It introduces a new quantitative methodology known as fuzzy logic (FL) and shows its potential in developing new effective CBT strategies to address bipolar thinking. The paper maintains that the roots of such thinking can be traced back to the Aristotelian logic which posits a 'black or white' view of the world. It is argued that a bipolar perspective is no longer defendable given recent developments in the field of literature, physics and logic. Moreover CBT can derive significant benefits by embracing the fuzzy logic paradigm. In particular it can, first, benefit by improving the degree of precision of its diagnostic tools and, second, by applying the FL principles to derive alternative strategies for inducing healthy changes in clients. Such improvements are believed to enhance CBT profile in terms of the degree of realism, flexibility and efficiency of its methods. The illustrations offered throughout this paper are based on the two main CBT perspectives; rational emotive behaviour therapy (REBT) and cognitive therapy (CT).     

Universal Health Coverage: Solution or Siren? Some Preliminary Thoughts

In recent years, there has been a growing groundswell of support for the idea that universal health coverage should be provided even in the developing world. While I wholeheartedly agree with the eventual goal of attaining universal health coverage globally, and the sooner the better, I have worries as to whether the world's rich countries, or institutions like the World Health Organization, should be pushing the world's poorest countries to take whatever steps are necessary to achieve that goal. My fear is that universal health coverage in the developing world is an intoxicating, but potentially dangerous, idea whose time may not yet have come. This article's aim is not to settle the question of whether the developing world should be urged, or pushed, to adopt policies of universal health coverage. It is merely to explore some worries about the wisdom of such a tack. The article is divided into eight sections. In Section 1, I give a brief introduction. In Section 2, I provide some background for my topic. In Section 3, I discuss the notion of universal health coverage, and what the push for such a goal in the developing world seemingly involves. In Section 4, I raise some general worries I have about the push for universal health coverage in the developing world. In Section 5, I present a wide range of possible justifications for universal health coverage in the developing world. In Section 6, I discuss whether any of the purported justifications of universal health coverage in the developing world actually do so. In Section 7, I consider some comments, objections, and responses. Finally, in Section 8, I offer a brief conclusion.     

Who goes to World Youth Day? Some data on under‐18 Australian participants

World Youth Day (WYD) beginning in 1985 and held internationally every two or three years is amongst the largest gatherings of young people in the world. In 1995, for example, the WYD held in Manila attracted over four million pilgrims. With a high level of participation as well as longevity WYD has become a significant social phenomenon, especially in an era where there is a sustained and widespread disaffiliation of youth from mainstream Churches. Participants at WYD are mainly Catholics although the invitation to take part is extended to all. There has been little empirical work on who attends WYD and their motivations for attending. This paper will report on research conducted on Australian youth who attended the 2005 WYD in Cologne. This research will use both quantitative and qualitative techniques to try and build up a profile of WYD pilgrims and explore some of their motivations for attending.     

L’accès aux médicaments : quelles contributions des règles sur les brevets de l’Accord de partenariat transpacifique global et progressiste ?

Enhanced protection for patents in free trade agreements would undermine access to medicines and show difficulties for developing countries with respect to public health issue. In the context of the Comprehensive and Progressive Trans-Pacific Partnership Agreement, however, after the withdrawal of the United States, the legal regime applicable to patents seems less rigid and, therefore, more favorable to access to medicines. This results, on the one hand, from certain flexibilities contained in this agreement itself; and on the other hand, the suspension of some material and procedural obligations. This article aims to analyze these two sides to justify the contribution of this agreement to ensure access to medicines.     

We Are the World—and They Are Not: Prototypicality for the World Community,Legitimacy, and Responses to Global Inequality

The relation between developed and developing countries is characterized by inequalities that sometimes hinder actions against worldwide problems. The current research presents an intergroup approach, based on the ingroup projection model, towards an analysis of psychological processes that perpetuate global inequality on a social group level. Precisely, we argue that people from developed countries perceive their group as more prototypical for the world population than they perceive people from developing countries. These perceptions of ingroup prototypicality should in turn relate to legitimacy beliefs and predict unfavorable behavioral intentions towards developing countries. We present two studies that corroborate our hypotheses: In Study 1, participants from a developed country perceived their ingroup as more prototypical for the superordinate group (i.e., world population) than the outgroup (i.e., developing countries), which in turn was related to beliefs that global inequality is legitimate. This finding was replicated in Study 2, and the predicted effect of ingroup prototypicality on behavioral intentions was mediated by legitimacy beliefs. These findings demonstrate that intergroup processes can contribute to perpetuating global inequality.     

Cognitive-behaviour therapy for depersonalisation disorder: an open study

Depersonalisation (DP) and derealisation (DR) are subjective experiences of unreality in, respectively, one's sense of self and the outside world. These experiences occur on a continuum from transient episodes that are frequently reported in healthy individuals to a chronic psychiatric disorder that causes considerable distress (depersonalisation disorder: DPD). Despite the relatively high rates of reporting these symptoms, little research has been conducted into psychological treatments for this disorder. We report on an open study where 21 patients with DPD were treated individually with cognitive behavioural therapy (CBT). The therapy involved helping the patients re-interpret their symptoms in a non-threatening way as well as reducing avoidances, safety behaviours and symptom monitoring. Significant improvements in patient-defined measures of DP/DR severity as well as standardised measures of dissociation, depression, anxiety and general functioning were found at post-treatment and six-months follow-up. Moreover, there were significant reductions in clinician ratings on the Present State Examination (Wing, Cooper & Sartorius, 1974), and 29% of participants no longer met criteria for DPD at the end of therapy. These initial results suggest that a CBT approach to DPD may be effective, but further trials with larger sample sizes and more rigorous research methodology are needed to determine the specificity of this approach.     

Does emotional reasoning change during cognitive behavioural therapy for anxiety?

Emotional reasoning refers to the use of subjective emotions, rather than objective evidence, to form conclusions about oneself and the world. It is a key interpretative bias in cognitive models of anxiety disorders and appears to be especially evident in individuals with anxiety disorders. However, the amenability of emotional reasoning to change during treatment has not yet been investigated. We sought to determine whether emotional reasoning tendencies change during a course of routine cognitive-behavioural therapy (CBT). Emotional reasoning tendencies were assessed in 36 individuals with a primary anxiety disorder who were seeking treatment at an outpatient clinic. Changes in anxiety and depressive symptoms as well as emotional reasoning tendencies after 12 sessions of CBT were examined in 25 individuals for whom there was complete data. Emotional reasoning tendencies were evident at pretreatment assessment. Although anxiety and depressive symptoms decreased during CBT, only one of six emotional reasoning interpretative styles (pertaining to conclusions that one is incompetent) changed significantly during the course of therapy. Attrition rates were high and there was not enough information regarding the extent to which therapy specifically focused on addressing emotional reasoning tendencies. Individuals seeking treatment for anxiety disorders appear to engage in emotional reasoning, however routine individual CBT does not appear to result in changes in emotional reasoning tendencies.